A Message from Courtney Medical Group

Thoughts Hurt

Sometimes just the idea of doing something causes anxiety and stress. Shutting us down before we even start. Thoughts are powerful. They can lift us up and help us to accomplish great things. Or throw us into the depths of despair, locking us inside our heads where nothing gets done. 

It may not even be based in reality. But the chemical reactions just thinking about attempting to walk our dogs, sit through dinner, exercise, or survive a day at work … are very real. One year I flew to Los Angeles to celebrate my daughter’s birthday. She wanted to go to Disneyland. For me, just the idea of standing in long lines, rides that threw me around and having to tolerate hours of pain before the midnight parade made my heart rate and breathing escalate. Don’t get me wrong. I love the park’s childhood innocence and silly fun all rolled into one. It’s just incredibly taxing, physically and emotionally. But I had a routine that worked since she was a little girl – swallow my pride and do whatever is necessary to survive. In this instance, it meant to park in the handicap spots directly in front of the entrance, get wheeled around by my child and use a cane when entering and exiting each ride. 

That year, when we drove into the parking lot, the handicap spots by the entrance were gone, built up with stores and eateries. Now everyone had to park in a garage, blocks away and ride a tram to the park. I was overwhelmed. Adding this extra step was more than I could handle. An extra half hour at the start of our day was hard enough, but after 12 hours, to endure this extra challenge was more than I could imagine handling. Just the anticipation shut me down. I became anxious, short tempered and withdrawn. I couldn’t say no to her birthday desire any more than I could explain the turmoil going on inside my head.

For those of us suffering with chronic pain just the thought of putting ourselves in a compromising position can be too much to handle. Learning to get out of our head and think clearly is the only way to see if it’s a real obstacle and if so, make appropriate plans to move forward.

How many times have you rejected offers to meet friends, go to a party, the theatre, because of what might happen? Or how others would react if you needed help or had to leave early? For many of us, the past has defined how we interact in the future. We’ve discussed multiple ways to help stop this process:

Guided imagery

Progressive muscle relation

Graded responses 



Another way to manage thoughts is by addressing the thoughts directly and understanding they don’t have to control or decide what path we choose to follow. They are just one part of our response to stressors. They don’t have to be the final say. It all starts with healthy thinking. We control very little in our lives. Too often this feeling of helplessness creates a cycle of despair and inactivity. But we can control what we think. Learning how to change negative thoughts to positive ones can impact pain in tremendous ways. 

Sadly, a negative thought can have far more impact than a positive one. As human beings we tend to let the negative ones seep into our core, compliments we slough off as someone “just being nice” but not really meaning it. That has to change. We need to appreciate ourselves, honor ourselves and see ourselves in a positive light. It has to come from within.

Here are some techniques to managing negative thoughts.


Are your thoughts positive or negative? We all talk to ourselves. Think about the world around us, its impact on our feelings, wellbeing. This self-talk can be helpful and rational or negative and detrimental. When negative, stop, write it down so you can see how often they occur, and then change the thought altogether.

“Today has been a good day, I know that won’t last.”

Changes to,

“I had a good day. Tomorrow can be one as well.”

Imagine hearing it in a silly voice. This removes its power.

Printing it on a balloon, then popping it.

Putting it in a bubble that floats away.

By seeing it in this light it may not seem so daunting.


Is this thought helpful? Is it true? Are you focusing on the negative by filtering out the positive? When you have a good day do you diminish it, instead of focusing on those moments you do feel better and acknowledging more, can and will, lie ahead? 

Do you have expectations that may set up failure?

“If I exercise for five minutes, I’ll feel great and be able to do so much more each day.”


“This medical treatment will take away my pain.”

Managing chronic pain takes a variety of resources, and constant perseverance in mobilizing and stretching joints and muscles. Believing one intervention is all we need is a set up for failure.

Do you use absolutes- never, always? Is everything all or nothing? Focus on the middle ground. Those days you felt better, what helped? Complete a list and go-to strategies for days negative thoughts are overwhelming. Be creative. Instead of quitting work because sitting is too painful. Ask for a more flexible schedule, work from home, a better chair, or the ability to change positions frequently.


How have the negative thoughts improved your situation? Why not replace them with positive, healthier ones and see what happens? Look at those you wrote down? Are they real, helpful? Were there ways you could have changed what happened, tweaked a response? Negative thoughts done have to be all right or all wrong. They can point us in a better direction.

“Yes I exercised for thirty minutes and hurt. Maybe next time I should start with five.”

The goal is to encourage positive, transformative thoughts naturally. It’ll take time and work. What’s the worst thing that can happen? There’s no question we feel better we are upbeat and happy.

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